PCOS, or polycystic ovary syndrome, is an incredibly common women’s health issue, affecting approximately 1 in 10 women in the UK alone. As a hormonal condition, it affects almost every system in the body, resulting in a wide range of symptoms such as weight gain, irregular, painful periods, fertility issues, oily skin, acne, excess male-pattern hair growth and hair loss - not to mention the emotional burden that accompanies the condition (1). While there is currently no specific treatment for PCOS, addressing the underlying hormonal imbalances through simple lifestyle changes can dramatically reduce the symptoms, and it all starts with the gut...
We know the health of the gut is implicated in lots of different health conditions, and PCOS is no exception. Although we still have lots more to learn about the gut, it is clear that a diverse range of healthy microbes makes for a healthy gut. Interestingly, research shows higher rates of gut dysbiosis (an imbalance between ‘good’ and ‘bad’ microbes) and low diversity in gut bacteria in women with PCOS, which could be contributing to disease progression (2).
PCOS is an inflammatory condition, with low-grade systemic inflammation being both a contributor and a consequence of symptoms (3). When living with any condition implicated by inflammation, the health of the gut is an incredibly important factor to consider. As our gut is intrinsically linked with our immune system, it plays a pivotal role in controlling systemic inflammation (you can read more about the gut and inflammation here). It is thought that intestinal permeability (commonly referred to as leaky gut) is a key factor involved in the inflammation seen in PCOS, as pathogens are able to pass directly to the bloodstream without first being screened by the immune system, resulting in an inflammatory immune response (4).
The gut-brain axis may also play a part in some of the emotional symptoms associated with PCOS, such as heightened anxiety and depression. Our gut and brain are in constant communication and when our gut isn’t happy, our brain feels it, and vice versa. Our gut is responsible for creating more than 90% of our serotonin, our ‘happy’ hormone, but cannot do this effectively if it is inflamed, leaky or otherwise off balance. Not surprisingly, one study has shown those with PCOS have lower circulating levels of serotonin compared to healthy women (5).
What can I do?
By focusing on supporting gut integrity and increasing the diversity of gut microbes, both physical and emotional symptoms of PCOS can be improved. Fibre plays an important role in management of the condition, so include plenty of roots, shoots and fruits to help your microbes flourish; this is particularly poignant as fibre reduces the risk of developing type 2 diabetes and cardiovascular disease, both comorbidities associated with PCOS (6). Swap refined carbohydrates (such as white bread, rice and pasta) for wholegrain versions, as these release much slower into the bloodstream, supporting blood sugar balance and inflammation (to read more about how blood sugar affects inflammation, click here). Specific supplements, such as anti-inflammatory omega 3, have also been shown to be beneficial for PCOS symptoms, due to their effects on reducing systemic inflammation. Finally, take holistic steps to reduce cortisol and inflammation levels, like prioritising sleep, managing stress and reducing alcohol and caffeine - all of which will also support a healthy gut.
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